@layout("/common/_container.html"){
<link href="${ctxPath}/static/css/weixin/market_addPatient.css?v=20140829" rel="stylesheet">
<div style="display: none">
    <input type="hidden" id="numValue" value="${num}">
    <input type="hidden" id="id" value="">
    <input type="hidden" id="oneChannelValue" value="">
    <input type="hidden" id="twoChannelValue" value="">
    <input type="hidden" id="thrChannelValue" value="">
    <input type="hidden" id="consumptionHabits">
    <input type="hidden" id="characters">
    <input type="hidden" id="economicAbility">
    <input type="hidden" id="occupation">
    <input type="hidden" id="maritalStatus" value="0">
</div>
<div class="addPatient" id="reservationsInfoForm">
    <!--头部-->
    <div class="addPatientHeader">
        <div onclick="ReservationsInfoDlg.patient()">取消</div>
        <div>新建患者</div>
        <div style="text-align: right" onclick="ReservationsInfoDlg.addSubmit('2')">保存</div>
    </div>
    <!--内容-->
    <div class="addPatientContent">
        <div>
            <div class="flexBox">
                <div>姓名 <span class="asterisk">*</span></div>
                <div><input type="text" id="customerName" placeholder="请填写姓名"></div>
            </div>
            <div class="flexBox">
                <div>性别</div>
                <div>
                    <select id="sex" name="sex">
                        <option value="0">未知</option>
                        <option value="1">男</option>
                        <option value="2">女</option>
                    </select>
                </div>
            </div>
        </div>
        <div>
            <div>
                <div style="flex: 5;">
                    <span>号码 <span class="asterisk">*</span></span>
                    <input type="text" id="customerPhone" placeholder="请添加手机" style="width: 80%;">
                </div>
                <div class="telephone">
                    <select name="phoneSharShip" id="phoneSharShip" style="width: 100%"></select>
                </div>
            </div>
            <div style="display: none" id="dianHua">
                <div style="flex: 5;">
                    <span>号码2&nbsp;&nbsp;&nbsp;</span>
                    <input type="text" placeholder="请添加手机" id="customerPhone2" style="width: 80%;">
                </div>
            </div>
            <div>
                <div style="text-align: center;border: none;color: #00a6c9;width: 100%;" onclick="$('#dianHua').toggle()">添加号码</div>
            </div>
        </div>
        <div>
            <div class="flexBox">
                <div>年龄</div>
                <div><input type="text" id="customerAge" style="padding-right: 0.5em;" placeholder="请输入年龄"></div>
            </div>
            <div class="flexBox">
                <div>状态 <span class="asterisk">*</span></div>
                <div>
                    <select id="statuss" name="statuss">
                        <option value="">请选择</option>
                        <option value="待定">待定</option>
                        <option value="跟进">跟进</option>
                        <option value="预约">预约</option>
                    </select>
                </div>
            </div>
        </div>
        <div>
            <div class="flexBox">
                <div>预约项目 <span class="asterisk">*</span></div>
                <div>
                    <select id="appointmentPayService" name="appointmentPayService"></select>
                </div>
            </div>
            <div class="flexBox">
                <div>预约时间 <span class="asterisk">*</span></div>
                <div>
                    <input type="text" id="appointmentArrivalTime" readonly="readonly" placeholder="请选择" style="width: 70%;margin-right: 1.2em;"
                           onclick="laydate({istime: true, format: 'YYYY-MM-DD hh:mm:ss'})">
                    <span class="glyphicon glyphicon-menu-down" style="color: #999999;margin-right: 4px;font-size: 16px"></span>
                </div>
            </div>
            <div class="flexBox">
                <div>预约门诊 <span class="asterisk">*</span></div>
                <div>
                    <select id="outpatientName" name="outpatientName"></select>
                </div>
            </div>
            <div class="flexBox">
                <div>预约病种 <span class="asterisk">*</span></div>
                <div>
                    <select id="accessDisease" name="accessDisease">
                        <option value="">请选择</option>
                        <option value="种植">种植</option>
                        <option value="正畸">正畸</option>
                        <option value="修复">修复</option>
                        <option value="美白">美白</option>
                        <option value="牙周">牙周</option>
                        <option value="医院类">医院类</option>
                        <option value="拔牙智齿">拔牙智齿</option>
                        <option value="洗牙洁牙">洗牙洁牙</option>
                        <option value="儿童齿科">儿童齿科</option>
                    </select>
                </div>
            </div>
        </div>
        <div>
            <div class="flexBox">
                <div>一级渠道 <span class="asterisk">*</span></div>
                <div>
                    <select id="oneChannel" name="oneChannel"></select>
                </div>
            </div>
            <div class="flexBox">
                <div>二级渠道 <span class="asterisk">*</span></div>
                <div>
                    <select id="twoChannel" name="twoChannel"></select>
                </div>
            </div>
            <div class="flexBox">
                <div>三级渠道 <span class="asterisk">*</span></div>
                <div>
                    <select id="thrChannel" name="thrChannel"></select>
                </div>
            </div>
        </div>
        <div>
            <div class="flexBox">
                <div>客户详情</div>
                <div><input type="text" id="remarks" placeholder="请填写客户详情"></div>
            </div>
            <div class="flexBox">
                <div>地址</div>
                <div><input type="text" id="address" placeholder="请填写地址"></div>
            </div>
        </div>
    </div>
</div>
<script src="${ctxPath}/static/modular/marketing/reservations/reservations_addToNew.js?v=20140829"></script>
<script src="${ctxPath}/static/js/common/jsChannel.js?v=20140829"></script>
<script>
    var oneChanneli = document.getElementById("oneChannelValue").value;
    var twoChanneli = document.getElementById("twoChannelValue").value;
    var thrChanneli = document.getElementById("thrChannelValue").value;
    var ChannelList;
    $.post(Feng.ctxPath + "/channel/getChannelsss", function (data) {
        ChannelList = data;
        channelInit('oneChannel', 'twoChannel', 'thrChannel');
    }, "json");
</script>
@}
